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AHIMA Convention Product World Presentation—PHI Disclosure Efficiency in the Business Office


During the 2018 Annual AHIMA Convention & Exhibit in Miami, MRO hosted the Product World presentation “A Case Study for PHI Disclosure Efficiency in the Business Office—Yale New Haven Health.” I was fortunate to have the opportunity to co-present the session with Cindy Zak, Executive Director of Corporate Health Information Management, Yale New Haven Health.

In her position, Zak is well aware of the challenges HIM professionals face in response to the rising volume of Release of Information (ROI) requests made to business offices to support payment of claims. Business office personnel can spend up to 40 to 45 percent of their day pulling and attaching medical records, taking them away from their core responsibilities. Mostly billers and collectors, these staff typically lack expertise in ROI and Protected Health Information (PHI) disclosure management. And, whenever medical records are handled, HIPAA concerns must be top priority, such as the minimum necessary requirement. Other industry challenges include:

  • Increased backlogs
  • High-priority requests requiring timely fulfillment
  • Complicated/disparate processes
  • Incomplete and inconsistent data collection and trackability
  • Convoluted issue resolution processes
  • Lack of transparency
  • Strained relations among business office, HIM and payers

Together we explored new PHI disclosure management technologies and workflows for improving collaboration between HIM and the business office when fulfilling additional documentation/claim attachment requests.

Addressing PHI Disclosure Challenges in the Business Office

Yale New Haven Health experienced many of the common industry challenges, especially the need for transparency in HIM and an efficient HIM procedure for billing releases. Because the business office maintained ownership of payer requests, HIM was uninformed, serving as a middleman to process thousands of pages. Averaging 20 cases of paper a week resulted in an additional $3,000 per month expense just in paper costs. And, once records were pulled and copied—often including more than the minimum necessary—the information was sent back to the business office for shipping to payers.

As an early adopter of MRO’s business office medical record attachment solution, Yale New Haven Health has already achieved positive outcomes:

    • Business office staff is focused on billing and collecting.
    • HIM staff is focused on pulling the requested medical records.
    • Only the portion of the medical record that is requested is being sent.
    • Paper processes have shifted to electronic delivery.
    • Workflows are based on payer specifications.
    • Medical record claims attachments are sent within 24 hours of receipt.
    • Requests are now trackable to promote transparency.

According to Zak, “Our system business office and HIM personnel collaborate more effectively, focusing on their core responsibilities to maximize productivity and efficiency. The new technology and workflows have reduced paper processes, creating significant cost savings and enhancing enterprise-wide compliance.”

As MRO extends its expertise for health information exchange into business office functions that support revenue cycle management, health systems can benefit from improved efficiency, cost savings, reduced financial risk, trackable delivery, and enhanced interdepartmental and payer collaboration.

To learn more about strategies to improve PHI disclosure efficiency in the business office, fill out the form below to receive a copy of AHIMA’s 2018 Product World Presentation

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Heard at AHIMA 2018—Privacy, Cybersecurity and Information Governance Institute and ROI Roundtable

AHIMA’s 2018 Privacy, Cybersecurity and Information Governance (PCIG) Institute took place September 22-23 at the 2018 AHIMA National Convention & Exhibit in Miami. True to its aim to enhance knowledge regarding current trends and issues, the event focused on protecting patient information across all healthcare settings and business operations—essential to ensuring patients’ trust in our healthcare system. Protected Health Information (PHI) disclosure management is at the heart of building that trust—and Information Governance (IG) is a critical component.

This year’s institute focused on industry adoption of IG, citing AHIMA’s Information Governance Adoption Model (IGAM)™ as a guide to advance IG practices toward achieving Level 5 maturity. Here are the five levels:

1—Unaware, IG concerns not addressed

2—Limited progress, early stage

3—Defined policies and procedures

4—Proactive program throughout operations

5—Fully integrated into overall infrastructure and business processes

Most attendees indicated their organizations were either at Level 2 or somewhere between Levels 2 and 3—making limited progress and beginning to define policies. This feedback means there’s much work to be done within the HIM domain to successfully measure and achieve IG maturity.

PHI Disclosure Management and IG Connection

A common question posed to HIM leaders on this topic is: What is the relationship between PHI disclosure and IG? First of all, proper disclosure of PHI cannot be achieved without adherence to IG principles—particularly privacy and security. AHIMA describes IG as an enterprise-wide framework for managing information throughout its lifecycle—from the inception of a patient’s record to its eventual destruction. An analogy that comes to mind is the story of a person’s life, the stewardship required from birth to death.

From an IG perspective, HIM professionals must know where information originates, where it flows, how it is released, when it dies—and all risk factors along the way. In our experience, one of the most critical areas of risk is the business office. Implementation of a centralized, enterprise-wide approach to PHI disclosure—aligned with IG principles—reduces risk related to ROI practices.

Modern Age of ROI Roundtable

Following the two-day PCIG institute, I joined my colleague Angela Rose, MHA, RHIA, CHPS, FAHIMA, Vice President of Implementation Services for MRO, and other experts to discuss Release of Information (ROI) challenges and best practices during the ROI Networking Roundtable “The Modern Age of ROI—Are You Up to Date?”

The hottest topic that emerged was patient-directed requests. Many in the industry are seeing inappropriate attorney behavior such as having the patient sign a blank form that the attorney then uses to request patient information. When a form is questionable, the patient should be contacted to clarify and confirm consent.

In the audience was Jim Bailey, President of the Association of Health Information Outsourcing Services (AHIOS), who suggested that states come together to address the issue. Here are four recommended strategies:

  • Raise awareness with your legislators
  • Hold conversations with other hospitals in your area
  • Don’t be afraid of meeting with the OCR
  • Exercise the right to question and verify any request

A valid patient-directed request must clearly reflect the patient’s intent—type of information requested, who should receive the information, for what purpose and method of delivery.

HIM Leadership

Overall, the PCIG Institute, ROI Roundtable and many other informative sessions during the AHIMA Convention reaffirmed that HIM professionals play a crucial role in promoting stronger privacy, security and Information Governance. Trust in the healthcare system depends on our leadership.

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MRO Is Top Performer in 2018 KLAS Report that Compares Release of Information Vendors

In September 2018, KLAS published the performance report “Release of Information 2018: Who Delivers Most Consistently Across Customers?” With a track record of being the KLAS “Category Leader” for ROI, as designated in 2013-2018 “Best in KLAS” reports, we were eager to dig into the latest research to see if MRO had again received the highest performance ratings.

We were not disappointed. I’m pleased to report that KLAS named MRO the overall highest performing ROI services vendor, outperforming the two other vendors included in the report. Only three ROI service providers had statistically adequate client bases to be included.

Key Findings: 2018 Release of Information KLAS Report

Key findings centered on MRO’s ROI services are:

  • On a 100-point scale, MRO’s reported overall performance score is 90.4.
  • MRO’s performance ratings for overall satisfaction, quality of service staff and turnaround time are rated highest among the vendors.
  • MRO is noted as the consistent high performer and well-rounded firm with good communication, good employees and strong delivery of ROI services.
  • 95 percent of MRO’s clients say they would hire the company again, a percentage much higher than the other vendors.
  • MRO has the proven scalability to meet large client needs and implementations.

As I read through the report, it was apparent that quality is a key theme related to MRO’s services. Our “top notch employees and outstanding customer service” are highlighted, and KLAS’s research finds that MRO clients appreciate the responsiveness of our customer service, especially the ease of speaking with someone when needed.

Reflecting a bit, I felt the emphasis on high-quality service within this report echoed findings in the last KLAS report to feature a deep dive into ROI: “HIM Services Performance 2015: Coding, Transcription, Release of Information.” In the 2015 report, MRO was recognized for the best overall performance, highest quality and fastest turnaround times.

Since the 2015 HIM report was released, MRO has grown to be one of the largest ROI vendors, serving more than 7,500 locations nationwide. It is rewarding to see that our clients continue to recognize our work as the highest quality service in the industry as we continue to expand.

That brings me to another topic. Scalability. MRO’s ability to scale to provide quality ROI services to both large and small clients is also noted in the 2018 report. One surveyed HIM director said, “We don’t see any issues with MRO being able to scale to meet our needs. When we asked to amend our contract, we were asking for a couple of FTE equivalents, and since that time we have lost some key staff members. So, MRO is ready to expand. Our experiences with them have all been either very good or excellent. They are very reputable.”

I personally believe MRO client feedback provided to KLAS is a strong indicator of high-level client satisfaction. As we onboard more of the nation’s top health systems, we are making the necessary investments in technology and people to ensure we continue delivering the best service quality while meeting the needs and expectations of our clients.

Video: MRO: KLAS-rated #1 for Release of Information

In 2012, MRO became the first rated vendor in KLAS’s Release of Information services market segment. Since then, MRO has been consistently rated #1 for ROI, and we closely monitor our performance scores to ensure MRO clients receive the best service possible.  Watch the video to learn more.

I am proud that MRO’s people, technology and uncompromising commitment to our clients’ success are recognized by KLAS, not only in relation to the other ROI vendors, but also on an objective performance scale.

To read more about KLAS’s research on Release of Information, complete the form below.

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